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access icon free Peripheral arterial disease screening for hemodialysis patients using a fractional-order integrator and transition probability decision-making model

  • Author(s): Jian-Xing Wu 1 1 ; Chien-Ming Li 2 2 ; Guan-Chun Chen 1 1 ; Yueh-Ren Ho 3 3 ; Chia-Hung Lin 4 4
    • View affiliations
    • Affiliations: 1: National Synchrotron Radiation Research Center, Hsinchu Science Park, Hsinchu 30076, Taiwan ;
      2: Division of Infectious Diseases, Department of Medicine of Chi Mei Medical Center, Tainan City 710, Taiwan ;
      3: Department of Biochemistry, Medical College of National Cheng Kung University Tainan City, Tainan 70101, Taiwan ;
      4: Department of Electrical Engineering, Kao-Yuan University, Kaohsiung City 82151, Taiwan
  • Source: Volume 11, Issue 2, April 2017, p. 69 – 76
    DOI:  10.1049/iet-syb.2016.0046 , Print ISSN 1751-8849, Online ISSN 1751-8857
© The Institution of Engineering and Technology
Received 10/11/2016, Accepted 16/01/2017, Revised 14/01/2017, Published 20/01/2017

Atherosclerosis and resultant peripheral arterial disease (PAD) are common complications in patients with type 2 diabetes mellitus or end-stage renal disease and in elderly patients. The prevalence of PAD is higher in patients receiving haemodialysis therapy. For early assessment of arterial occlusion using bilateral photoplethysmography (PPG), such as changes in pulse transit time and pulse shape, bilateral timing differences could be used to identify the risk level of PAD. Hence, the authors propose a discrete fractional-order integrator to calculate the bilateral area under the systolic peak (AUSP). These indices indicated the differences in both rise-timing and amplitudes of PPG signals. The dexter and sinister AUSP ratios were preliminarily used to separate the normal condition from low/high risk of PAD. Then, transition probability-based decision-making model was employed to evaluate the risk levels. The joint probability could be specified as a critical threshold, < 0.81, to identify the true positive for screening low or high risk level of PAD, referring to the patients’ health records. In contrast to the bilateral timing differences and traditional methods, the proposed model showed better efficiency in PAD assessments and provided a promising strategy to be implemented in an embedded system.

Inspec keywords: blood vessels; decision making; photoplethysmography; probability; diseases; geriatrics

Other keywords: transition probability-based decision-making model; sinister AUSP ratio; bilateral photoplethysmography; joint probability; diabetes mellitus; discrete fractional-order integrator; end-stage renal disease; haemodialysis therapy; transition probability decision-making model; peripheral arterial disease screening; elderly patients; fractional-order integrator; PPG signals; bilateral area; arterial occlusion; dexter AUSP ratio; bilateral timing differences; systolic peak; hemodialysis patients

Subjects: Optical and laser radiation (biomedical imaging/measurement); Patient diagnostic methods and instrumentation; Probability theory, stochastic processes, and statistics; Haemodynamics, pneumodynamics; Optical and laser radiation (medical uses); Other topics in statistics

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